Smoking Blamed for 'Epidemic' in U.S. Women / Tobacco-Related Disease Called An Epidemic in U.S. Women

Sabin Russell, Chronicle Medical Writer

Published 4:00 am, Wednesday, March 28, 2001

In its first report in 21 years on women and smoking, the surgeon general's office declared yesterday that cigarettes have caused a "full-blown epidemic" of tobacco-related disease among American women.

Surgeon General David Satcher released the 675-page tome at a Washington, D. C., press conference, where he portrayed a 600 percent increase in lung cancer death rates among women since 1950 as the product of tobacco-industry marketing.

The report is a bitter epilogue to a story that began in the 1940s and 1950s, when women adopted the tobacco habits of American men, and it underscores the irony of the 1960s slogan, "You've come a long way, baby," which promoted a cigarette brand designed for women.

"Tobacco advertisements suggest that women who smoke are liberated, sexually attractive, athletic, fun loving and slim; whereas in reality women who smoke are often nicotine dependent, physically unhealthy, socioeconomically disadvantaged or depressed," Satcher said in a preface to his report.

Since 1987, lung cancer, once rare in women, has surpassed breast cancer as the leading cause of female cancer death in the United States. Last year, 67, 600 American women died of lung cancer, 27,000 more than were claimed by breast cancer.

California's tobacco control program often is cited as a national model for smoking prevention efforts. Smoking is banned in California offices, restaurants and bars, and smokers must pay a tobacco tax of 87 cents on every pack. Smoking rates in California are down. Only 15 percent of California women smoke, compared to 22 percent nationwide. Male smoking rates also are lower: 20.5 percent in California, compared to 26 percent nationwide.

When Surgeon General Julius Richmond issued the first report on the health consequences of tobacco use among women in 1980, it pointed to the first signs of an epidemic. Today, Satcher said, that epidemic has become full-blown. Tobacco-related diseases -- cancer, heart disease and emphysema -- accounted for 165,000 deaths of American women in 1997.

Since that first report was published in 1980, 3 million American women have died prematurely because of smoking, according to Secretary of Health and Human Services Tommy Thompson. On average, epidemiologists calculated, those women died 14 years before their time.

'EVILS OF SMOKING'

Thompson told reporters he will launch a national campaign against the "evils of smoking," and he said he personally favors regulation of the industry.

Efforts by the Clinton administration to order the Food and Drug Administration to regulate tobacco were blocked by the Supreme Court. "Speaking only for myself, I think that tobacco should be regulated," Thompson said. "It's up to Congress to pass legislation" granting the FDA such authority.

Michael Pfeil, a spokesman for tobacco giant Philip Morris Co. in New York, said his company now supports FDA regulation regarding the sale of tobacco products to minors. "Everyone agrees that kids shouldn't smoke, and that more needs to be done to prevent young boys and girls from smoking," he said.

'CIGARETTES ARE ADDICTIVE'

Pfeil also said his company supports the efforts of the surgeon general to educate the public about the health effects of smoking, and he acknowledged that "cigarettes are addictive."

However, he said tobacco companies should continue to "market responsibly to adults who have made the decision to smoke," both in the United States and abroad.

While the surgeon general's report revealed nothing not reported previously about the damaging health effects of tobacco, there was special emphasis on the problems of marketing American cigarettes abroad. "Thwarting increases in the use of tobacco among women around the world represents one of the greatest health opportunities of our time," Satcher said in the report.

Virginia Ernster, associate director of the University of California at San Francisco Cancer Center and senior scientific editor of the new surgeon general's report, also stressed the new global aspect of tobacco control.

"Women in the United States are smoking less, so the tobacco industry has clearly gone abroad, and is targetting women in developing countries," she said. As such, the U.S. tobacco industry is exporting "a preventable epidemic" of cancer and heart disease, she added.

MILLIONS DIE PREMATURELY

Tobacco use is responsible for the premature deaths of 4 million men and women in the world each year, Ernster said. By 2025, that figure will rise to 10 million, with 70 percent of those deaths in the developing world.

On Market Street in San Francisco, 19-year-old Charlene Yuzal listened to the grim statistics in the surgeon general's report, and flicked her cigarette butt onto the brick sidewalk. "It makes me want to quit," she said. "I'll probably get there someday."

But Yuzal, who has been smoking since she was 12, acknowledged that kicking the habit won't be easy. "It calms me down. It relaxes me," she said.

Roxanne Burise of Berkeley also believes she will stop smoking, "eventually. " Burise, 20, said she started smoking three years ago because her friends also smoked. "It's basically addictive," she said. "I'll be 21 in May. I'll stop on my birthday."

Virginia Ernster, senior science editor for the surgeon general's report, will speak about it at 9:45 a.m. Saturday at the UCSF Women's Health 2020 Conference at Cole Hall, 513 Parnassus Ave., San Francisco. For more information, call (415) 820-8565.

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